Those were all previous trade treaties, negotiated and ratified under former presidents. The Obama White House wants to assure progressives that the Trans-Pacific Partnership (TPP) is going to be different. In an email to supporters last week, the president touts the upsides of the TPP, writing that it will “[level] the playing field for American workers,” that it’s “good to the environment,” and most importantly that it’s “consistent with my top priority as president: making sure that more hard-working Americans have a chance to get ahead.”

The TPP is a treaty being negotiated between the United States and Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, and Vietnam, with the goal of creating a NAFTA-style free trade zone between said countries. The negotiations began in 2005 and are reportedly nearing their conclusion.

Allies of the president are quick to point out that progressive skepticism of the TPP is premature because the text of the treaty remains private—so secret that while trade advisers from some of the largest companies in the world have access to its contents, members of Congress have vocally complained that their access has been severely restricted.

Trust, without any ability to verify. The president is demanding that Congress pass trade promotion authority, sometimes called “fast track,” legislation, which would only allow for 90 days between the TPP being revealed to the public for the first time and its passage in Congress, with the legislative branch forgoing its prerogative to amend the treaty. This removes any opportunity to build significant opposition to the treaty.

There is the rub. Corporations, trade associations, lobbyists, Wall Street-funded think tanks, and other institutions pushing for passage are waging their fight based on experiences with previous treaties and the legislative goodies they think they will receive. (And of course the leaks from the 600 “trade advisors” letting them know how their industries will benefit.)

But the White House is right. It would be unfair to tar them with the track record of, for example, the Clinton White House’s history on trade. And as it happens, we don’t need to. The current White House’s own record is damning on its own.

At the end of 2010 President Obama signed and pushed for passage of the Korea Free Trade Agreement. First signed by President Bush in 2007, the treaty was not ratified by the newly Democratic Congress.

Barack Obama reopened negotiations and in December 2010 he signed an updated version of the treaty. Because the treaty was first signed in 2007 it was grandfathered into the fast-track legislation passed during the Bush administration that formally expired in 2007, clearing the path for the newly Republican House of Representatives to ratify the treaty in 2011.

In his 2011 State of the Union address, the president touted the benefits of the U.S.-Korea agreement, telling Congress, “Last month, we finalized a trade agreement with South Korea that will support at least 70,000 American jobs.”

Using language similar to his TPP advocacy, the president said, “Before I took office, I made it clear that we would enforce our trade agreements, and that I would only sign deals that keep faith with American workers, and promote American jobs.” He continued, “That’s what we did with Korea, and that’s what I intend to do as we pursue agreements with Panama and Colombia, and continue our Asia Pacific and global trade talks.”

Three years since ratification of the Korea treaty, we can ask ourselves how it is living up to its promise. Public Citizen’s Global Trade Watch recently released a fact sheet updating the performance of the Korea Free Trade Association, and there appears to be a misalignment between rhetoric and reality.

Over the past three years, “the U.S. goods trade deficit with Korea has ballooned an estimated 84 percent, or $12.7 billion.” Using the administration’s own “trade-jobs ratio” this cost our economy “nearly 85,000 American jobs.”

What’s more, far from the promised panacea of newly opened markets leading to increased access for U.S. manufacturers, “U.S. goods exports to Korea have fallen an estimated 5 percent, or $2.2 billion,” according to Global Trade Watch. During the same period, imports from Korea increased by $10.5 billion.

These statistics aren’t surprising. They simply add the Korea Free Trade Association to a scrap heap of treaties that have failed to live up to their promises to the American worker.

Even more frightening are the outcomes if we take the administration at its word on the benefits of the Trans-Pacific Partnership.

A fact sheet distributed by the Progressive Coalition for American Jobs, a newly created pro-TPP astroturf group, states that “according to analysis supported by the Peterson Institute, by 2025 TPP is estimated to increase U.S. exports by $123.5 billion.”

Never mind that the membership list of organizations that are part of the Progressive Coalition for American Jobs seems to be a secret as heavily classified as the actual text of the TPP. Also please ignore the fact that one of the researchers who concocted the Peterson Institute’s rosy forecasts for NAFTA (abominably predicting a gain of 130,000 jobs in five years) later told the Wall Street Journal that “the lesson for me is to stay away from job forecasting.”

If Peterson’s $123.5 billion estimate bucks the trend of the likes of NAFTA, the WTO, and permanent normalized trade relations, and it comes to fruition, what would it actually mean for the U.S. economy? Less than half of 1 percent of our gross domestic product. Economist Dean Baker points out, “This is presumably mostly due to greater efficiency, but if half was due to increased labor supply it would only translate into 300,000 additional people working.” This amounts to less than six weeks of employment gains in the current economy.

Therein lies the problem. Even under the rosiest scenario, TPP would lead to modest economic gains. Meanwhile, historic precedent, including the Korea Free Trade agreement negotiated and signed by President Obama, portends disastrous economic consequences.

President Obama made sweeping moves on Thursday to help more Americans access paid time off to care for their families.

The president signed an executive order to give federal employees up to six weeks of paid family leave after the birth, adoption, or foster placement of a new child.

The president will call for new funding to help states and municipalities pass their own paid leave laws, which some have already done.

He will also urge Congress to pass the Healthy Families Act, which would let workers earn up to seven days of paid sick leave per year, as well as new legislation that would give workers an additional six weeks of paid time off.

Announcing the new initiatives in a post on LinkedIn, senior advisor Valerie Jarrett said that family leave is “a worker’s right, not a privilege,” and that “the success and productivity of our workers is inextricably tied to their ability to care for their families and maintain a stable life at home.”

More than 40 million Americans have no access to paid sick leave, and the United States is alone among developed nations in offering no paid maternity or paternity leave.

The burdens of caring for a sick child fall most heavily on women, especially low-income women who are less likely to have the workplace benefits needed to care for a family.

The six weeks of paid leave mandated by the new executive order will be an advance on the paid sick leave that employees already accrue, so it would have to be paid back over time.

“Working families need and deserve the economic security of earning paid sick days so that moms and dads can care for a sick child without sacrificing a day’s pay or losing their job altogether,” said Sen. Patty Murray (D-WA) and Rep. Rosa DeLauro (D-CT) in a joint statement commending the president’s actions. “Look no further than this season’s worse-than-expected flu outbreak to show why those who are sick should not be at work.”

The anti-immigration amendment was sponsored by Rep. Marsha Blackburn (R-TN), who is also the co-sponsor of a federal bill banning abortion after 20 weeks of pregnancy with no exceptions for fetal anomalies or for a woman’s health unless her life is in danger.

An amendment to a bill funding the Department of Homeland Security through the end of the year prohibits the department from spending any money to process applications for Obama’s deferred deportation programs.

These include the Deferred Action for Childhood Arrivals (DACA) program, which has been in place since 2012 and has already protected about 600,000 young people brought to the United States as children. They have all undergone criminal background checks, and many already have work permits.

The House’s anti-immigration amendment also defunds Obama’s 2014 executive order, which slightly expanded DACA and extended protection to more than four million unauthorized immigrants who are parents of U.S. citizens.

The anti-immigration amendment was sponsored by Rep. Marsha Blackburn (R-TN), who is also the co-sponsor of a federal bill banning abortion after 20 weeks of pregnancy with no exceptions for fetal anomalies or for a woman’s health unless her life is in danger.

Congress only gives immigration enforcers enough money to deport about 400,000 unauthorized immigrants per year. Since roughly 11 million unauthorized immigrants live in the United States, enforcers have to prioritize who to spend money on deporting and who to leave in peace. That’s where Obama’s executive actions and other directives come in, and that priority-setting is what Republican lawmakers seek to upend.

The measure won’t become law anytime soon since Obama has vowed to veto anything that undermines his immigration actions, but it does threaten a partial government shutdown and shed light on Republican values when it comes to immigrant communities.

Tensions rose further following President Obama’s June declaration of intent to use executive action to address what he termed a “humanitarian crisis” and the continued federal inaction on comprehensive immigration reform he deemed partially responsible.

July was a hotbed of debate. Protesters demonstrated both for and against the migrants and their future in the United States. Partisan and bipartisan congressional proposals called for the migrants’ expedited removal. The Obama administration in turn requested funds to quickly process migrants. Ultimately, affairs ended in an August standstill, as Congress began its vacation with few significant results.

Among other places, the comment sections of Internet articles overflowed with discussions of immigration policy and immigrants themselves; many commenters had opinions on who should come, who should stay, and the framework that the general public, policymakers, and advocates should use to answer these questions. As public health researchers concerned with the effects of immigration policy on health, we aim to stay informed on current immigration-related events. There is a general understanding among us, however, that the comment sections of immigration articles are dangerous spaces to tread—spaces we should avoid—as they are often filled with vitriol directed at supporters and, most directly, at immigrants.

But language is powerful. Metaphor and rhetoric have the power to shape thoughts on policy and those it affects. And insight into the reasoning behind anti-immigrant sentiments can inform advocates on which strategies may be most effective in combating these harmful messages. Thus, we argue that it is important to critically consider how immigrants are categorized in political discourse in these spaces, as it has implications for their acceptance, health, and well-being.

Simply put, we as advocates can’t avoid comment sections.

We decided to systematically consider the comment sections of news articles posted online to investigate any particular themes or trends that might emerge, as well as reflect on the implications of this language. We selected three articles from CNN, often considered a relatively moderate media outlet, as the center of our study. We focus here on a June article published on CNN’s website, selected both for its publication early in the news cycle, as well as its representation of how most major media outlets understood and reported on this situation at the time. After one of us reviewed 500 comments from this article in July, the rest of our team later read through the comments individually and placed them in one of the categories we initially developed, revising the scope where needed. We then revisited the categories, now filled with specific comments, to consider the themes within. We found, unsurprisingly, that comments were overwhelmingly negative. But rather than brush off the comments, we argue that their tone and content have important implications for the health and well-being of immigrants and Latino/as (henceforth: Latinos).

An overall racist and xenophobic mindset was clear. In fact, conversation often shifted from Central American minors to focus on Latino and immigrant populations in general, usually conflating the groups. Latinos were characterized as unwilling and unable to assimilate into “U.S. culture,” and accused of attempting a physical and cultural takeover of the United States to create what one commenter called a “mestizo dominated hellhole.” In particular, this often took the form of attacks on Spanish-speaking immigrants or Latinos.

In contrast to commenters’ framing of past generations of “good,” hardworking, white European immigrants, commenters thought of Latino immigrants as inherently “bad”—too lazy to effect change in their own countries and over-reliant on U.S. social services (despite contradictory evidence). Moreover, commenters characterized these so-called “unskilled, uneducated” Latino immigrants as unnecessary and useless to the U.S. labor system—in line with the history of racial (and labor-related) exclusion the U.S. immigration system has enacted for years.

Not all rhetoric was so subtle. Commenters often explicitly demonstrated how little they valued the lives of immigrants generally and Latinos specifically. From describing migrants entering the United States as “garbage” that “slithers in here over [the] border” to a “flood” of children, commenters clustered Latinos, Latino immigrants, and Central American minors into one indistinguishable force of brown interlopers corroding the white, English-speaking, pulled-up-by-their-bootstraps “American dream.” In the eyes of many commenters, then, despite fleeing contexts of violence and povertylinked tofree trade policies, U.S. intervention in Central America, and high levels of U.S. incarceration and deportation of Central Americans, these minors (and their families) did not and should not belong in the United States. Rather, mothers were described as “anchor machines,” hyper-fertile women “breeding like mice” and exploiting their children to gain U.S. social benefits. In turn, their children were vermin to be eradicated, for, as one commenter noted, “Baby cockroaches grow up to be full grown cockroaches.”

In this way, commenters framed migrants’ bodies and lives as criminal, inhuman (if not animal), and less worthy than the bodies and lives of the commenters and their own children, who they claimed should receive benefits before children from elsewhere, no matter their relative need.

Many commenters had intensively violent proposals for how to handle this alleged invasion. Most abhorrent were proposals for military force to “eradicate” the problem of undocumented immigrants and unaccompanied minors. Some suggested “purging” Central America of the violent gangs that have grown in power and violence through drone strikes. Others supported firing squads or drones that would “kill on sight” any of the “terrorists” (read: undocumented immigrants) attempting to cross the U.S.-Mexico border.

This frequently mentioned send-in-the-drones mentality conveyed a clear message: Whatever the method, a militarized U.S. response toward Central Americans (and Latinos) was necessary to prevent the purported violence, criminality, and threat to “American” culture that undocumented migrants, young or old, could carry across the southern U.S. border.

Reading through these comments, their anti-immigrant nature is obvious. But why do they matter?

Marginalized groups—in this case, undocumented immigrant minors—can be placed into categories that devalue and dehumanize them. Such dehumanization can justify or encourage anything from the restriction of life-saving resources to the outright killing of those no longer seen as valuable to human society. The great danger in these comments, then, is not only that they homogenize undocumented minors and undocumented immigrants, but that they dehumanize them as well. As a rhetoric of uprooting “pests” becomes more acceptable, the lives of undocumented immigrants are devalued—be it for race, ethnicity, immigration status, or socioeconomic status—and militarized “solutions” to both their migration and existence become more palatable and “logical.”

This homogenization also works by lumping together disparate communities, including U.S.-born Latinos, permanent residents, undocumented immigrants, unaccompanied minors, and Latinos across lines of descent and origin, thereby applying a catch-all racism and xenophobia to these minors. Moreover, this generalization makes it difficult to see how these minors’ unique needs must be met—as children, as refugees from nations with heavy U.S. involvement, and as individuals who sometimes speak indigenous languages instead of English or Spanish. Coupled with dehumanization, these minors are depicted as not meriting “special” help from federal or local institutions, and ultimately receive little assistance as they navigate demanding immigration and asylum systems.

This rhetoric has real-world effects. Commenters’ thoughts, ideas, and actions are spread and embodied by protests, demonstrations, and appeals to legislators. Legislators in turn will hear the most vocally opinionated—and extreme opinions make easy media fodder. Further, commenters’ radical rhetoric normalizes less radical but still damaging public opinions.

Unfortunately, these discourses also exist outside the confines of Internet comment sections. In his November 2014 speech on executive action, President Obama referred to these Central American minors as a “brief spike” in unaccompanied children journeying to the United States, completely ignoring the “humanitarian crisis” he once emphatically stated needed to be addressed. Beyond dismissing these refugees’ struggles, President Obama went on to create a dichotomy between the “felons” and “criminals” he promises to deport and the “families” and “children” he aims to provide with relief. In a nation where so many have been trained to see Latinos, immigrants, and unaccompanied minors as inherently criminal, however—and criminality and human rights as exclusive, for that matter—how can we expect any of these groups to receive the support they need, much less these apparently forgotten minors?

These comment sections offer insight into the thoughts and nativism held by members of the public. Most importantly, though, they remind us that as social media becomes increasingly central to advocacy efforts and politics, we must analyze ever more critically the emerging discourses we find within these online realms, seeking out signs of dehumanization and preparing for the restriction, violence, and denial that may both contribute to and flow from it. In this particular instance, immigrant rights advocates must continue to engage in education against stereotypical and dehumanizing conceptualizations of immigrants, Central Americans, Mexicans, and U.S.-born Latinos. Simplistic views of the various social and economic factors contributing to migration and immigration should be combated with efforts to inform the general public of the past and present ways the U.S. government has intervened in Latin America, as well as the changing nature of the context of arrival for immigrants in the United States over time. Ultimately, however, perceptions of immigrants as less than human must be torn down by a focus on their humanity and their own recounting of their experiences. Especially in a world of online media, it is therefore critical that we center the voices of unaccompanied, undocumented Central American minors in reporting, education, and conversation—in the end, it is their well-being at stake.

The Senate confirmed 59 Obama nominations, including a dozen judges who will serve lifetime appointments on the federal bench. Controversial anti-choice nominee Michael Boggs was not among them.

Boggs came under fire for a series of anti-choice votes, including a bill that would have published the names of abortion doctors online, and for his support of a same-sex marriage ban and a Confederate symbol on the Georgia state flag.

“Boggs’ defeat is a victory for women, LGBT equality, and racial justice,” NARAL Pro-Choice America president Ilyse Hogue said in a statement. “At a time where our rights are under fire in the courts, Americans will not accept the elevation of a nominee with a clear history of anti-choice bias as the price of a ‘deal’ struck to fill federal judicial vacancies.”

That deal was one struck between the Obama administration and Georgia’s two senators to include Boggs in a package of seven nominees in exchange for the senators not using their veto power against any of the nominations.

The nominees that went through were a victory for diversity in the Obama presidency.

The judges confirmed included Robert Pitman, the first openly gay judge to sit on the federal bench in Texas, and Loretta Biggs, the first Black woman to serve as a district judge in North Carolina.

Obama has gotten more judges confirmed this year and overall in his presidency than his predecessors, with 89 district and circuit court judges confirmed this year alone, and a total of 305 confirmations in his six years as president.

Oddly enough, he can also thank Sens. Ted Cruz (R-TX) and Mike Lee (R-UT), whose procedure-bucking insistence on anti-immigration votes late Friday night kept the Senate in session over the weekend and provided more time to set up confirmation votes.

Murthy was one of a staggering 69 nominees who were able to be confirmed since Friday night.

“Because of the antics of Ted Cruz and Mike Lee, we were able to end the 113th Congress on a high note,” a senior Democratic leadership aide told RH Reality Check. “Senator Reid and the Democratic caucus showed tremendous unity and perseverance to push through many important nominations before the end of the year.”

On Thursday, the Senate rejected a last-minute Republican effort led by Sens. Jeff Sessions (R-AL) and Ted Cruz (R-TX) to scuttle President Obama’s current and future efforts at immigration reform.

If successful, the move would have prevented President Obama from taking executive action on immigration reform, and would have sunsetted the Deferred Action for Childhood Arrivals (DACA) program, which gives millions of young undocumented immigrants a two-year reprieve from deportation and work authorization.

The move involved a complicated aspect of Senate procedure.

Sessions wanted to offer anti-immigration amendments to the continuing resolution, a piece of legislation passed on Wednesday by the House that would fund the federal government through December 11 if also passed by the Senate.

But Senate rules limit the number of amendments that can be offered on any particular piece of legislation. So majority leader Harry Reid (D-NV) used a procedure called “filling the amendment tree”—offering the maximum number of amendments so that there was no room for any others. Sessions moved to table Reid’s amendment tree, but the Senate defeated his motion in a 50-50 tie. Fifty-one votes were needed to pass it.

By rejecting the Sessions motion, the Senate averted a possible crisis—the House and Senate needed to agree on an identical continuing resolution to keep the government funded. Disagreement between the two bodies over whether to include the anti-immigrant provisions in the bill could have led to a government shutdown.

The Sessions motion was political as well as ideological. It forced vulnerable Democratic incumbents into a potentially difficult vote heading into the last few weeks of a re-election campaign that will likely feature Republicans portraying Democrats as “pro-amnesty” for supporting programs like DACA.

Five Democrats, four of whom face difficult re-election fights this November, joined all 45 Republicans in voting yes: Kay Hagan (D-NC), Mary Landrieu (D-LA), Joe Manchin (D-WV), Mark Pryor (D-AR), and Jeanne Shaheen (D-NH). All but Manchin are up for re-election this year, and this vote could give them some political cover on the campaign trail while still giving Reid the exact number of votes he needs to squash the anti-immigration amendments.

The Senate passed the final version of the continuing resolution by a vote of 78 to 22.

There is a human cost of delay, less dramatic than deportations but no less destructive to immigrant communities: lack of access to affordable health care, both for unauthorized immigrants and for some who are in this country legally.

President Obama announced last weekend that he would delay taking executive action on immigration until after the November elections, despite his earlier promise that he intended to do something by the end of the summer. It seemed to be a move to protect vulnerable Senate Democrats, but some criticized that reasoning, and many immigrant rights advocates were left feeling deeply betrayed.

“He made a promise to our communities,” Kimberly Inez McGuire, director of public affairs at the National Latina Institute for Reproductive Health (NLIRH), told RH Reality Check. “People wept with hope at the power of that promise, that some kind of relief was coming to the communities that are suffering. He’s now gone back on that promise.”

The promise didn’t contain policy specifics, but advocates hoped the president might grant relief from deportation to as many as five million of the nation’s estimated 11 million unauthorized immigrants. He might even allow some of them to get work permits and Social Security numbers, which hundreds of thousands of young “DREAMers” now have thanks to the 2012 Deferred Action for Childhood Arrivals (DACA) program.

Breaking that promise by delaying action further has real, daily, human costs—in the 60 days or so until the election, an estimated 60,000 people could be deported, and millions more must continue to live in fear of deportation each day.

But there is another human cost of delay, less dramatic than deportations but no less destructive to immigrant communities. That cost is the lack of access to affordable health care—both for unauthorized immigrants and for some who are in this country legally.

“Women are living today with undiagnosed cervical and breast cancer who can’t see a doctor because of their immigration status,” Inez McGuire said. “When I think about the Latinas we hear from, this is an urgent issue—they cannot wait another day to find out if that lump in their breast is cancer.”

That’s the situation Lorena is in. She is the sole caretaker for her special-needs son who doesn’t qualify for Medicaid because he is undocumented, and she can’t afford to get a Pap smear or a mammogram because programs that covered her health-care needs have been cut. “I really want to see a doctor because when I touch my breast I can feel a sort of lump,” Lorena said. “I don’t know if it’s an abscess or something more serious. So I need to see a doctor but haven’t been able to.”

Reproductive health care is a particular concern, advocates say, because women are the backbone of immigrant communities but are less likely than other groups to get the health care they need. Immigrant women are disproportionately represented among poor women of reproductive age, but they are almost twice as likely as poor native-born U.S. women to lack health insurance. They have higher birthrates and, because they are disproportionately young and poor, have a higher risk for sexually transmitted infections.

The Affordable Care Act was supposed to increase access to health care for lower-income people, and to give women access to no-cost contraception and other crucial preventive reproductive health care. But the widely acknowledged public health benefits of affordable reproductive health care, advocates say, are off-limits to immigrant women who can’t afford the care they need due to legal restrictions.

NLIRH was one of 181 human rights organizations to sign a letter just before Labor Day to President Obama, urging him to make sure immigrants get affordable health-care access when he takes administrative action.

“We know this is a president who has fought for access to health coverage,” Natalie Camastra, policy analyst at NLIRH, told RH Reality Check. “But we’re very concerned that that is not being extended to immigrant women and families.”

There’s good reason to think Obama might leave health care by the wayside even when he finally does address immigration, advocates say. Shortly after the DACA program was implemented, the Obama administration banned DACA recipients from accessing affordable federal health coverage—Medicaid, the Children’s Health Insurance Program (CHIP), and the subsidies and exchanges under the Affordable Care Act (ACA). Everyone else who is granted deferred deportation has access to those programs, but the administration changed its policy to specifically exclude the young DREAMers who got DACA.

DREAMers, named after the yet-to-pass DREAM Act that would provide a path to citizenship for undocumented people brought to the country as children, are mostly young people of reproductive age. To qualify for DACA’s two-year, renewable deportation deferral and work authorization, young people under 30 must have come to the United States before age 16, lived in the country for at least five years, be in or have graduated high school, and have no serious criminal records.

These young people, brought to this country through no fault of their own, turned to DACA for a temporary reprieve from both the fear of deportation and the burdens of being undocumented. But even though DACA recipients are considered “lawfully present” and have Social Security numbers, and even though they work and pay taxes that help fund federal health programs like Medicaid or the ACA, in most states their access to health care is no better than if they had no papers at all. Even in states like California, where DACA recipients are supposed to have access to the state’s low-income Medi-Cal program, many have been rejected due to confusion over eligibility.

And since DACA may well end up being a blueprint for wider immigration reform, there’s a danger that these inequities could be made law for generations of immigrants to come.

“To say to someone, ‘You can live here and work here, but if you get sick you’re out of luck,’ is simply inconsistent with our nation’s values,” Inez McGuire said. “It’s an unjust double standard where the same people who are invited to contribute to our economy are locked out of our health-care system.”

Undocumented immigrants, and lawfully present DACA recipients under the status quo, don’t have many options when it comes to health care. They could get health care through their employer, but they often work in industries like agriculture or domestic work that rarely offer employer-sponsored health care. They can purchase insurance individually, but it will be wildly expensive because they lack access to the subsidies or exchanges in the Affordable Care Act. That leaves unauthorized immigrants mostly with “safety net” providers like community health centers, which constantly face funding cuts and which can be too few and far between in some rural areas.

LGBT immigrants also face a double-bind when it comes to care, since they are already at higher risk of employment or relationship discrimination, so they are less likely to have employer-sponsored health insurance.

If nothing else, immigrants can rely on emergency room care—which many do, especially when it comes to giving birth. Any pregnant woman, in all 50 states, regardless of her immigration status, can get emergency Medicaid funding for labor and delivery in an emergency room. But if she wants prenatal care, which reduces the risk of complications and low birth weight, her level of care would depend heavily on the state she lives in.

“In some cases, immigrant women have access to health care while pregnant, and the moment they give birth, that coverage goes away,” Inez McGuire said. “The way the policy is written just fails to account for the entirety of a woman’s health.”

Even if a low-income immigrant woman broke her ankle while pregnant, Inez McGuire said, emergency Medicaid funds might not pay for it because it doesn’t directly relate to the pregnancy.

Ever since the 1996 “welfare reform” law was passed, lawfully present immigrants—that includes people with green cards, refugees, and anyone granted deferred deportation except DACA recipients—have had to wait five years until they can access affordable health-care services such as Medicaid, which is one option for low-income women seeking prenatal care.

There are some exceptions to this “five-year bar,” but they are an inconsistent patchwork that varies state by state. A federal program started in 2002 under President Bush allows states to use federal dollars to provide prenatal care to low-income immigrant women, regardless of their immigration status or when they arrived. But only 15 states have chosen to take that option. And in an anti-choice twist, the program works by granting CHIP funding to the woman’s fetus. Advocates say that’s problematic because it creates fetal “personhood” language that undermines the woman’s autonomy and her right to an abortion if she needs one.

There is also coverage in about half the states for either low-income pregnant immigrant women, their children, or both, with some coverage dependent on the woman or child’s immigration status, and some not.

“Asking an immigrant to navigate this system is difficult when it takes a policy expert to understand it,” Camastra said. “It’s so, so complicated.”

There are clear, if dubious, political reasons that immigrants have restricted access to health care. Many people think immigrants come across the border to obtain “free” services (forgetting that immigrants pay taxes too). During the recent child migrant crisis, DACA became a scapegoat, with conservative politicians like Sen. Ted Cruz (R-TX) calling for an end to the program because they feared it was luring these children to come to the United States. It almost certainly wasn’t; the migrant influx began before DACA was implemented, and most who arrived had never heard of it. But this kind of fearmongering is a steep obstacle, for both advocates and Obama, against convincing the public that immigrant health needs are worth meeting.

Failing to meet those needs is “more than an injustice, more than an indignity—this is a denial of human rights, plain and simple,” Inez McGuire said. “Health care is a human right, and it shouldn’t depend on your immigration status, gender, or zip code.”

And meanwhile, the deportations will continue—along with the sometimes-nightmarish reproductive and sexual health crises that immigrants can face in detention centers. Pregnant women like Juana Villegas or Miriam Mendiola-Martinez are sometimes shackled during childbirth, and transgender people like Victoria Arellano often face especially appalling conditions—Arellano, who was HIV-positive, died after being taunted by guards and denied medical treatment.

But advocates aren’t going to give up on fighting for health-care access. They’re still lobbying Congress, including the most vocally anti-immigration-reform members. They’ve thrown their support behind the HEAL Act—HR 4240, the Health Equity and Access under the Law for Immigrant Women and Families Act of 2014, sponsored by Rep. Michelle Lujan Grisham (D-NM)—which would remove the five-year waiting period for lawful immigrants to access affordable federal health care and remove the restrictions on DACA recipients.

And they’re going to keep putting pressure on the president to do everything he can absent action from Congress.

“The community will not be sitting down, we will not be stepping back. We’re going to keep the pressure on as long as immigrant women and families continue to suffer,” Inez McGuire said. “There is no excuse for the president’s continued delay.”

On Monday, President Obama signed an executive order, promised a month ago, that will prohibit federal contractors from discriminating based on sexual orientation or gender identity.

“America’s federal contracts should not subsidize discrimination against the American people,” Obama said before signing the order. “I’m going to do what I can with the authority I have to act.”

The administration had been waiting to see if Congress would pass the Employment Non-Discrimination Act (ENDA), but it has stalled in the House after passing the Senate with a bipartisan supermajority.

The executive order will amend two earlier orders, one signed by Lyndon Johnson that prohibits federal contractors from discriminating based on race, sex, color, religion, or national origin, and another by Richard Nixon that extends such protections to government employees.

Obama did not bow to pressure from religious leaders to include a broad religious exemption, which ENDA did contain. In the wake of the Hobby Lobby Supreme Court decision that granted religious freedoms to corporations, LGBT groups had revoked their support for ENDA because they feared it could be used broadly to discriminate if an employer of a for-profit corporation has religious objections to homosexuality.

The president let stand language added to Johnson’s order by George W. Bush in 2002, which allows religiously affiliated federal contractors to favor members of their own faith in hiring decisions.

The act will affect about 30,000 companies employing 28 million people, or one-fifth of the U.S. work force.

Before President Obama addressed the first annual White House Summit on Working Families on Monday, hundreds of low-wage federally contracted workers dressed like Rosie the Riveter went on strike down the street to advocate for a better federal jobs policy.

Before President Obama addressed the first annual White House Summit on Working Families on Monday, hundreds of low-wage federally contracted workers dressed like Rosie the Riveter went on strike down the street to advocate for a better federal jobs policy.

The strike outside the National Zoo was organized by the Good Jobs Nation campaign, which has sponsored seven other strikes by federally contracted workers over the past year. The action highlighted the findings of a new report that says seven out of ten low-wage jobs sponsored by federal tax dollars are held by women, and that the president has the power to implement a federal “Good Jobs Policy” that would help lift more than 20 million workers out of poverty and into the middle class.

World War II’s Rosie the Riveters were federal contractors, organizers argued, and today’s low-wage service employees working in federal buildings are a new generation of Rosies. President Obama’s recent executive order to raise the minimum wage for federal contractors to $10.10 per hour was a good start, organizers and workers said, but it’s not enough to help working families.

Joanne Kenon, a 61-year-old grandmother who works at the National Zoo for $9.80 an hour, said she lives with her sister because she can’t afford to live on her own, and doesn’t think she will ever be able to afford to retire.

“Don’t get me wrong, I love my job,” Kenon told RH Reality Check.“But we need more money. We need benefits. We need respect.” A union that can regularly collectively bargain for better wages and benefits is the best way to accomplish those goals, she said: “We don’t need something that’s like every so often, a little bit every few years. We need something that’s on a regular basis.”

Kenon had never been on strike before, she said, but once an organizer told her about the strike she was immediately interested. She said other coworkers of hers at the National Zoo were interested but afraid to strike, and that she was the only one of her coworkers to join. “Of all the places we had to go on strike, it had to be at my job,” she said with a laugh. But she wasn’t worried for her job, and said that her boss seemed supportive of the action.

“I’m doing this for all of us,” Kenon said.

Although President Obama didn’t specifically address the need for collective bargaining in his speech at the Working Families Summit, he made a strong case for progressive family policies.

“Family leave, childcare, workplace flexibility, a decent wage—these are not frills, they are basic needs,” Obama said. “They shouldn’t be bonuses. They should be part of our bottom line as a society.”

He announced that he would sign a presidential memorandum to expand federal employees’ access to flexible work schedules, and urged Congress to pass the languishing Pregnant Workers Fairness Act in order to fight pregnancy discrimination in the workplace.

“Too often these issues are thought of as women’s issues, which I guess means you can kind of scoot them aside a little bit,” Obama said. “When women succeed, America succeeds.”

President Obama has asked his staff to prepare an executive order banning employment discrimination based on sexual orientation or gender identity for employers who contract with the government, a White House official confirmed Monday.

President Obama has asked his staff to prepare an executive order banning employment discrimination based on sexual orientation or gender identity for employers who contract with the government, a White House official confirmed Monday.

Specifics about the order are not known, but it will most likely amend an executive order issued by President Lyndon Johnson that barred federal contractors from discriminating based on race, sex, religion, or national origin in their employment decisions.

The administration has long held off on taking such an action, despite repeated calls to do so from LGBT groups and Democratic lawmakers, because it wanted to pressure Congress to pass the Employment Non-Discrimination Act (ENDA). That act would apply to private employers, and it passed the Senate last fall. But after Speaker of the House John Boehner (R-OH) made clear that the Republican-dominated House will not pass the bill this year, the administration once again decided to take matters into its own hands.

Obama has already signed several executive orders to get around Congress’s refusal to pass popular proposals that benefit working people. On Equal Pay Day, the president signed an order that strengthens efforts to close the gender pay gap for federal contractors, and earlier this year he ordered raising the minimum wage to $10.10 an hour for new federal contract employees.

The announcement comes the day before Obama is scheduled to appear at a prominent LGBT fundraising gala in New York for the Democratic National Committee.

“President Obama’s commitment to LGBT equality will be one of his lasting legacies,” Anthony D. Romero, executive director of the American Civil Liberties Union, said in a statement. “This President has done more for the struggle for LGBT equality than all previous presidents combined.”